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Revenue Cycle Analyst

1 month ago

Hasbrouck Heights, New Jersey, United States Hackensack Meridian Health Full time
Job Title: Revenue Cycle Analyst, Physician Billing

About the Role:

We are seeking a highly skilled Revenue Cycle Analyst to join our team at Hackensack Meridian Health. As a key member of our Revenue Cycle team, you will play a critical role in analyzing and resolving complex billing and reimbursement issues, ensuring accurate and timely payment for our patients.

Key Responsibilities:

  • Participate in weekly graph and workflow meetings to identify and analyze high-volume denials and underpayments.
  • Perform root cause analysis and present findings to the Revenue Cycle team, communicating improvement opportunities and corrective actions.
  • Act as a team leader, ensuring all team members are trained and aligned with established desktop and policies and procedures.
  • Collaborate with the Training department to develop education materials based on improvement opportunities presented at inter-disciplinary meetings.
  • Monitor daily dashboards and reports, conducting analytical reviews to determine if changes or enhancements to current policies and procedures are required.
  • Participate in meetings with various departments to communicate findings and recommendations to improve revenue management.
  • Work closely with front-end teams regarding up-front cash collection, registration, and eligibility denials.
  • Utilize and develop new Epic and ad-hoc accounts receivable or denial reporting tools for management.
  • Perform staff audits based on manual adjustment reports, reviewing activities to improve the revenue cycle and ensure compliance with governmental and commercial payer guidelines.
  • Monitor payments, denials, and initiates CPT or DRG analysis to determine reasons for denial.

Requirements:

  • Bachelor's degree or equivalent HMHN work experience.
  • Minimum of 4 years of related work experience.
  • Strong analytical, mathematical, and report writing skills.
  • Knowledge of computers or hospital billing systems.
  • Proficient in Microsoft Office or Google applications.
  • Excellent communication and interpersonal skills.

Preferred Qualifications:

  • Bachelor's degree.
  • Experience in healthcare.
  • Knowledge of Managed Care contracts, Medicare, and Medicaid.
  • Proficient in SMS, Epic, and/or other hospital billing systems.
  • Knowledge of ICD-9/10 and medical terminology.

Certifications:

  • Certification or Proficiency in Epic HB Fundamentals within 6 months of hire.
  • Certification or Proficiency in Epic HB Insurance Follow-Up within 3 months of hire.
  • Must successfully pass completion of EPIC assessment within 30 days after Network access granted.